Team Scaffolds: How Minimal In-Group Structures Support Fast-Paced Teaming

by Melissa A. Valentine and Amy C. Edmondson

Executive Summary —
It is increasingly necessary for 24/7 shift operations to include some component of team-based work. But how can organizations support such work among constantly changing groups of people in a setting where stable teams are not feasible? This research investigates an organizational structure the authors call team scaffolds: a role set with collective responsibility for accomplishing interdependent tasks. Studying the implementation of team scaffolding in a high-stakes setting, a city hospital emergency room, the authors observed that workers readily affiliated with the temporary teams—even without ongoing relationships—and worked together intensely during the short duration of these groupings, even developing a competitive dynamic with other team scaffolds. The role sets established job placeholders in an interdependent group so that people starting up a shift could take their places in the set and immediately understand the interdependence and accountability they shared with others. Overall, this design improved the ability and motivation of clinicians to engage in teaming. Key concepts include:

Team scaffolds, as team shells that can be instantly populated with transitory teams, is an organizational structure that may have broad applicability for supporting teams of people who work intense shifts together in virtual or actual settings.

Implementing the team scaffolding organizational design in a city hospital triggered significant changes in teaming networks and behaviors in ways that improved operational performance.

With team scaffolds the hospital supported teaming among people who were often strangers and among people who might work together intensely for six hours and then not again for a month. In the team scaffold, people starting a shift would come in and occupy their place in the role set.

Author Abstract

Across many industries, particularly in health care delivery, interdependent work is performed under conditions that make bounded stable teams infeasible, creating a need to understand factors that foster teaming in the absence of team stability. Teaming refers to coordination and mutual adjustment during episodes of interdependent work. The present research investigates teaming in the high-stakes, fast-paced setting of a hospital emergency room and focuses on the effects of a new organizational structure, which we call a team scaffold, on teaming effectiveness and performance outcomes. Using a multi-method research design with qualitative interview and observational data and quantitative operational data analyzed with adapted network methods, we examine whether and how team scaffolds facilitate teaming in a dynamic work environment. Although team scaffolds were implemented with little or no membership stability, their introduction triggered significant changes in teaming networks and behaviors in ways that improved operational performance. Implications of team scaffolds for theory and practice are discussed.